**Dear Doctors Team,**

I’ve been struggling with anxiety and uncertainty for the past 6 months, and I sincerely need your help to find peace of mind. I had two potential HIV exposures:

1. **Exposure 1**: Received unprotected oral sex and had protected vaginal intercourse.

2. **Exposure 2**: Engaged in mutual unprotected oral sex. During cunnilingus, I noticed blood in my mouth (uncertain if it was mine or hers); this lasted for about 5 minutes before I spat it out. I also have bleeding gums. I started PEP around 72–75 hours after this second exposure, as I initially believed it wasn't necessary.

There was a gap of approximately 6 weeks (43 days) between exposures. I tested HIV negative using a 4th-generation test:

* At 6 weeks after **exposure 1**

* At 6 months after **exposure 2**

**My questions are:**

1. Is the 6-week 4th-gen test conclusive for exposure 1?

2. Is the 6-month 4th-gen test conclusive for exposure 2, even though PEP was started late?

3. Can late initiation of PEP delay seroconversion beyond 6 months or even up to a year?

I've read comments from experts like Dr. HHH suggesting there's no ideal time to detect PEP failure. Given this, can I fully trust my 6-month result, or is there any chance it could still change?

I deeply appreciate your guidance and hope to move forward with confidence

I'm sorry you've been anxious and uncertain for so long. There really was no need. You describe two exposures that each had essentially zero risk for HIV. You've probably spent too much time online and seeing nonscientific information about HIV risks, especially about oral sex, blood exposure, and bleeding gums. Your initial belief about PEP was accurate:  we would not have advised PEP after the second event. There has never been a known case of HIV acquired by cunnilingus, regardless of menstruation or other blood exposure; and in general oral exposure (even to blood) carries little risk of transmitting HIV. And as you apparently know, starting as long as 72 hours after exposure means it was not highly reliable anyway.

However, your negative test results prove conclusively you did not acquire HIV. I'm nor sure where or how you gained the impression that I have advised "there's no ideal time to detect PEP failure" -- maybe an older thread? Or in response to a question that involved much earlier testing than your own? In any case, users also must be cautious about applying replies to other questions to their own situation. Our replies are tailored precisely to the specific questions asked and the users' needs, and very often there are nuanced differences that make the answer unreliable in other situations.

I hope these comments resolve your anxiety and uncertainty. Let me know if anything isn't clear.

HHH, MD

Also, thank you, Doctor, for your reply.

I have seen your responses both on this forum and on HealthTap as well.

1. My question is: if someone's PEP fails and they were already infected (e.g., due to a late start, etc.), would the follow-up testing still detect the infection? According to the CDC 2025 guidelines, a 12-week post-exposure test is considered conclusive for PEP follow-up, correct?

2. Also, if I had an infection from Exposure 1, wouldn't my 6-week result have been positive? Or would the 6-month post-Exposure 2 result detect that?

   PEP cannot delay detection of an infection that occurred a month before starting it, right? And the window period for this exposure would still be the same(12 week), even though PEP was started 42 days after Exposure 1?

3.also I have seen one video were they are saying that pep can delay seroconversion to 6 months to or beyond that?is that true doctor??

2. Yes, your negative 6 week test after the first exposure was very reliable. But that doesn't matter now: the second test proves you were not infected during either event.

3. No, it isn't true. That's old news and/or from unscientific or otherwise unreliable resources. It's just plain wrong.

You don't have HIV. Stop overthinking everything and believing you might be the world's first case of such delayed HIV test results. It never happens. Please do not ask anything more that comes from doubt about possibly having HIV. I will have nothing more to say about your negative HIV status.

1. I want to confirm if the result I received is final under all circumstances. If there has been no further exposure, will this result remain unchanged?

2. In one of your replies on HealthTap, you mentioned that “exact data do not exist.” Given that, how can PEP be considered conclusive at 3 months post-exposure? Especially in cases like mine, where PEP was started more than 72 hours after exposure.

3. I’ve also read about people who started PEP at around 96 hours. Would standard testing still be conclusive for them at 3 months, or would they require a longer window period, considering PEP may delay antibody production?

4. In a thread from 10 months ago, someone mentioned a person testing positive 6 months after exposure, and you replied that such cases usually involve PEP that may not have worked. Could you kindly clarify this point?

5. As I mentioned earlier, I believe my PEP might have failed since it was started late. In that case, is the 3-month mark still considered conclusive for me?

6. Just to be sure—if PEP fails, would a person typically test positive within 3 months post-exposure or post-PEP?

7. You've previously mentioned that the window period begins after PEP ends. Does that mean a 4th-generation test taken 45 days after completing PEP would be considered conclusive?

8. Also, I’ve read your comments on HealthTap and in this thread where you mentioned that in cases of PEP failure, there is *no optimal time* to determine when a test result would be conclusive. This has significantly increased my anxiety, as I’m really trying to move on, but such uncertainty holds me back. Could you please clarify this further too???

1. "I want to confirm if the result I received is final under all circumstances." Yes it is. If there has been no further exposure, will this result remain unchanged? Yes it will.

2. There has never been a known case of of standard testing not being conclusive by 6 months after PEP, or so rare it can be ignored.

3. Irrelevant to you since you didn't start PEP that late.

4. No. I have neither the time nor the energy, nor should you, to go back and analyzing that statement. You can be sure it doesn't apply to you.

5. No such thing happens. Re-read my replies above.

6. Yes.

8. Yes.

9. I warned you above about the danger in interpreting answers in one context to your own.

You are being argumentative to prove a point that doesn't exist. You do not have HIV. This thread is over. In the 21 years of this and our preceding forum, with thousands of questions from persons worried about HIV, none have yet reported they tested positive,  You will not be the first. If and when if ever happens, it will not be a trivial exposure like yours and there will not be false negative tests before a positive result shows up.

Please note the forum rule against repeated anxiety driven questions. Usually we allow one or two, but in this case any further questions you ask about these exposures, your HIV tests, and your fears of still having HIV will be deleted without reply and without refund of the posting fee. Thank you for your understanding. Good bye.